{"id":11143,"date":"2024-12-16T19:20:15","date_gmt":"2024-12-17T03:20:15","guid":{"rendered":"https:\/\/inlandmendodems.org\/WP\/?post_type=document&#038;p=11143"},"modified":"2024-12-16T19:20:15","modified_gmt":"2024-12-17T03:20:15","slug":"migs-form","status":"publish","type":"document","link":"https:\/\/inlandmendodems.org\/WP\/document\/migs-form\/","title":{"rendered":"MIGS FORM"},"content":{"rendered":"<div id=\"pl-11143\"  class=\"panel-layout\" ><div id=\"pg-11143-0\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-11143-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-11143-0-0-0\" class=\"widget_text so-panel widget widget_custom_html panel-first-child panel-last-child\" data-index=\"0\" ><div class=\"textwidget custom-html-widget\"><style>\n.form-group {\n    margin-bottom: 1.5em;\n}\n.form-group .main-label {\n    display: block;\n    margin-bottom: 0.5em;\n    font-weight: bold;\n     width: 75%;\n}\n.form-group .ckbox-control {\n    width: 10%;\n    padding: 0.5em;\n    font-size: 1em;\n    box-sizing: border-box;}\n\n.form-group .form-control {\n    width: 50%;\n    padding: 0.5em;\n    font-size: 1em;\n    box-sizing: border-box;\n}\n.form-group .form-description {\n\tdisplay:block;\n    margin-top: 0.25em;\n        margin-bottom: 0.5em;\n    font-size: 0.9em;\n     width: 75%;\n    color: #666;\n}\nbutton {\n\tdisplay:block;\n    margin: 0.5em 0; \/* Adds spacing around the button *\/\n          font-size: 1em;\n          padding: 0.2em 1em; \/* Adjusts the button's padding *\/ \n    color: black;\n}\n\n.flex-container {\n  display: flex;\n    flex-direction: row; \n    height:50px;\n    width:400;\n     gap: 10px; \/* Adds space between the radio buttons *\/\n     align-items: center; \/* Ensures the buttons and labels are aligned properly \n\n}\n\n.flex-container > div {\n\/*   background-color: #f1f1f1; *\/\n  margin: 5px;\n  padding: 10px;\n  font-size: 14px;\n}\ninput[type=\"radio\"] {\n  width: 20px;            \/* Set the width *\/\n  height: 20px;           \/* Set the height *\/\n  border-radius: 50%;     \/* Make it circular *\/\n  appearance: none;       \/* Remove default styling (for better cross-browser compatibility) *\/\n  border: 2px solid #333; \/* Set border color *\/\n  background-color: #fff; \/* Set background color *\/\n  cursor: pointer;       \/* Make it clickable *\/\n  outline: none;          \/* Remove focus outline *\/\n}\n\n\/* Optional: Change color on hover or checked state *\/\ninput[type=\"radio\"]:hover {\n  background-color: #f0f0f0;\n}\n\ninput[type=\"radio\"]:checked {\n  background-color: #4CAF50; \/* Change color when checked *\/\n  border-color: #4CAF50;     \/* Change border color when checked *\/\n}\n\n\n<\/style>\n\n<div class=\"form-group\">\n\n    <form action=\"<?php echo admin_url('admin-post.php'); ?>\" method=\"post\">\n\n<h2>Inland Mendocino Democratic Club <br>\nMembership Information Form<\/h2>\n<p>Application Form for Membership through 8\/31. Fields marked with * are required<\/p>\n\n  \n <div class=\"flex-container\">\n    <div><input type=\"radio\" id=\"new\" name=\"new_renew\" value=\"NEW\">\n    <label for=\"new\" > NEW <\/label><\/div>\n    <div><input type=\"radio\" id=\"renew\" name=\"new_renew\" value=\"RENEW\">\n\t<label for=\"new\" > RENEW <\/label><\/div>\n    <div><input type=\"date\" id=\"date\" name=\"date\">\n\t<label for=\"date\" > Date <\/label><\/div>\n<\/div> <br>\n  \n        <label for=\"name\"  class=\"main-label\"> FirstName <span class=\"frm_required\">*<\/span> <\/label>\n        <input type=\"text\" id=\"firstname\" name=\"firstname\"  value=\"\"  required data-reqmsg=\"First Name cannot be blank.\" \n        aria-required=\"true\" data-invmsg=\"First Name is invalid\" aria-invalid=\"false\" \n        class=\"form-control\"> \n        <small class=\"form-description\">Enter first name as registered<\/small>\n        \n        <label for=\"lastname\" class=\"main-label\">Last Name (Family Name)<span class=\"frm_required\">*<\/span> <\/label>\n        <input type=\"text\" id=\"lastname\" name=\"lastname\"  value=\"\"  required data-reqmsg=\"Last Name cannot be blank.\" \n        aria-required=\"true\" data-invmsg=\"Last Name is invalid\" aria-invalid=\"false\" \n        class=\"form-control\"> \n        <small class=\"form-description\">Enter last name on voter registration<\/small>\n     \n     \t<label for=\"name\" class=\"main-label\">Email <span class=\"frm_required\">*<\/span> <\/label>\n        <input type=\"email\" id=\"email\" name=\"email\"  value=\"\"  required data-reqmsg=\"Email cannot be blank.\" \n        aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\" \n        class=\"form-control\"> \n        <small class=\"form-description\">We send email to inform you of interesting and important events.<\/small>\n\n \t\t<input type=\"checkbox\" id=\"emailok\" name=\"emailok\" value=\"EMAILOK\">\n  \t\t<label for=\"emailok\"> OK TO EMAIL ME<\/label><br><br>\n  \n     \t<label for=\"name\" class=\"main-label\">Phone Number [123-456-7890]<\/label>\n     \t<input type=\"tel\" id=\"phone\" name=\"phone\"  pattern=\"[0-9]{3}-[0-9]{3}-[0-9]{4}\" \n        title=\"Phone number must be in the format: 123-456-7890\" \n        data-invmsg=\"Email is invalid\" aria-invalid=\"false\" class=\"form-control\"> \n\t\t<small class=\"form-description\">We call our active members to to inform you of events, actions, meetings and volunteer opportunities.\n<\/small>\n     \n      <input type=\"checkbox\" id=\"phoneok\" name=\"phoneok\" value=\"PHONEOK\">\n      <label for=\"phoneok\"> OK TO SEND ME VOICE MAIL<\/label> <br><br>\n      \n       <input type=\"checkbox\" id=\"textok\" name=\"textok\" value=\"SMSOK\">\n       <label for=\"textok\"> OK TO TEXT (SMS) ME <\/label>\n       <small class=\"form-description\">We send text messages to alert you of important events and dates.\nYou agree to receive automated Transactional messages. Terms and Privacy Policy can be found at https:\/\/inlandmendodems.org\/WP\/document\/sms-terms-and-privacy-policy\/ .You may receive up to 5 msgs\/mo. Text and data rates may apply. Reply STOP to end or HELP for help.<\/small>\n\/*******************************************************\/\n\n\n<fieldset>\n<legend>Physical Address - No PO BOX<\/legend>\n        <label for=\"street\"  class=\"main-label\">Street <span class=\"frm_required\">*<\/span> <\/label>\n        <input type=\"text\" id=\"firstname\" name=\"firstname\"  value=\"\"  required data-reqmsg=\"First Name cannot be blank.\" \n        aria-required=\"true\" data-invmsg=\"First Name is invalid\" aria-invalid=\"false\" \n        class=\"form-control\"> \n        <small class=\"form-description\">Address on your voter registration<\/small>\n        \n        <label for=\"city\" class=\"main-label\">City<span class=\"frm_required\">*<\/span> <\/label>\n        <input type=\"text\" id=\"city\" name=\"city\"  value=\"\"  required data-reqmsg=\"Last Name cannot be blank.\" \n        aria-required=\"true\" data-invmsg=\"Last Name is invalid\" aria-invalid=\"false\" \n        class=\"form-control\"> \n\t\t<small class=\"form-description\">Enter last name on voter registration<\/small>\n        \n<label class=\"main-label\" for=\"us-states\">Select a State <span class=\"frm_required\">*<\/span><\/label>\n  <select class=\"form-control\" id=\"us-states\" name=\"states\" required form=\"migs_form\">\n    <option value=\"\">--Select a State--<\/option>\n    <option value=\"AL\">Alabama (AL)<\/option>\n    <option value=\"AK\">Alaska (AK)<\/option>\n    <option value=\"AZ\">Arizona (AZ)<\/option>\n    <option value=\"AR\">Arkansas (AR)<\/option>\n    <option value=\"CA\">California (CA)<\/option>\n    <option value=\"CO\">Colorado (CO)<\/option>\n    <option value=\"CT\">Connecticut (CT)<\/option>\n    <option value=\"DE\">Delaware (DE)<\/option>\n    <option value=\"FL\">Florida (FL)<\/option>\n    <option value=\"GA\">Georgia (GA)<\/option>\n    <option value=\"HI\">Hawaii (HI)<\/option>\n    <option value=\"ID\">Idaho (ID)<\/option>\n    <option value=\"IL\">Illinois (IL)<\/option>\n    <option value=\"IN\">Indiana (IN)<\/option>\n    <option value=\"IA\">Iowa (IA)<\/option>\n    <option value=\"KS\">Kansas (KS)<\/option>\n    <option value=\"KY\">Kentucky (KY)<\/option>\n    <option value=\"LA\">Louisiana (LA)<\/option>\n    <option value=\"ME\">Maine (ME)<\/option>\n    <option value=\"MD\">Maryland (MD)<\/option>\n    <option value=\"MA\">Massachusetts (MA)<\/option>\n    <option value=\"MI\">Michigan (MI)<\/option>\n    <option value=\"MN\">Minnesota (MN)<\/option>\n    <option value=\"MS\">Mississippi (MS)<\/option>\n    <option value=\"MO\">Missouri (MO)<\/option>\n    <option value=\"MT\">Montana (MT)<\/option>\n    <option value=\"NE\">Nebraska (NE)<\/option>\n    <option value=\"NV\">Nevada (NV)<\/option>\n    <option value=\"NH\">New Hampshire (NH)<\/option>\n    <option value=\"NJ\">New Jersey (NJ)<\/option>\n    <option value=\"NM\">New Mexico (NM)<\/option>\n    <option value=\"NY\">New York (NY)<\/option>\n    <option value=\"NC\">North Carolina (NC)<\/option>\n    <option value=\"ND\">North Dakota (ND)<\/option>\n    <option value=\"OH\">Ohio (OH)<\/option>\n    <option value=\"OK\">Oklahoma (OK)<\/option>\n    <option value=\"OR\">Oregon (OR)<\/option>\n    <option value=\"PA\">Pennsylvania (PA)<\/option>\n    <option value=\"RI\">Rhode Island (RI)<\/option>\n    <option value=\"SC\">South Carolina (SC)<\/option>\n    <option value=\"SD\">South Dakota (SD)<\/option>\n    <option value=\"TN\">Tennessee (TN)<\/option>\n    <option value=\"TX\">Texas (TX)<\/option>\n    <option value=\"UT\">Utah (UT)<\/option>\n    <option value=\"VT\">Vermont (VT)<\/option>\n    <option value=\"VA\">Virginia (VA)<\/option>\n    <option value=\"WA\">Washington (WA)<\/option>\n    <option value=\"WV\">West Virginia (WV)<\/option>\n    <option value=\"WI\">Wisconsin (WI)<\/option>\n    <option value=\"WY\">Wyoming (WY)<\/option>\n  <\/select><br><br>\n     \n        <label for=\"zip\" class=\"main-label\">ZIP <span class=\"frm_required\">*<\/span> <\/label>\n        <input type=\"email\" id=\"email\" name=\"email\"  value=\"\"  required data-reqmsg=\"Email cannot be blank.\" \n        \taria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\" \n        class=\"form-control\"> \n       <small class=\"form-description\">We send email to inform you of interesting and important events.<\/small>\n  \n  <\/fieldset>\n  <fieldset>\n  <legend>Occupation><\/legend>\n   <h4>Campaign finance law requires us to collect your occupation and employer.<\/h4>\n         <label for=\"occupy\"  class=\"main-label\"> Occupation <span class=\"frm_required\">*<\/span> <\/label>\n        <input type=\"text\" id=\"occupy\" name=\"occupy\"  value=\"\"  required data-reqmsg=\"First Name cannot be blank.\" \n        aria-required=\"true\" data-invmsg=\"First Name is invalid\" aria-invalid=\"false\" \n        class=\"form-control\"> \n        <small class=\"form-description\"> Are you currently employed? Enter RETIRED if you are retired.<\/small>\n        \n        <label for=\"employer\" class=\"main-label\">Last Name (Family Name)<span class=\"frm_required\">*<\/span> <\/label>\n        <input type=\"text\" id=\"employer\" name=\"employer\"  value=\"\"  required data-reqmsg=\"Employer Name cannot be blank.\" \n        aria-required=\"true\" data-invmsg=\"Employer is invalid\" aria-invalid=\"false\" \n        class=\"form-control\"> \n        <small class=\"form-description\">Enter last name on voter registration<\/small>\n<\/fieldset>\n\n          <?php wp_nonce_field('my_form_submission_action_nonce', 'my_form_submission_nonce'); ?>\n        \n               <button type=\"submit\" class=\"btn button-primary\"> Join IMDC<\/button>\n        <input type=\"reset\" value=\"Reset Form\">\n    <\/form>\n    \n    \n\n\n<\/div><\/div><\/div><\/div><\/div><\/div>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ngg_post_thumbnail":0,"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"footnotes":""},"document_category":[],"document_tag":[],"class_list":["post-11143","document","type-document","status-publish","hentry","post"],"_links":{"self":[{"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/document\/11143","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/document"}],"about":[{"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/types\/document"}],"author":[{"embeddable":true,"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/comments?post=11143"}],"version-history":[{"count":2,"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/document\/11143\/revisions"}],"predecessor-version":[{"id":11145,"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/document\/11143\/revisions\/11145"}],"wp:attachment":[{"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/media?parent=11143"}],"wp:term":[{"taxonomy":"document_category","embeddable":true,"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/document_category?post=11143"},{"taxonomy":"document_tag","embeddable":true,"href":"https:\/\/inlandmendodems.org\/WP\/wp-json\/wp\/v2\/document_tag?post=11143"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}